Health and Hospitals System Board Meeting January 24, 2014

Chair David Carvalho announced that Dr. Raju is likely to be confirmed as the new head of the New York City Health and Hospital System, so an interim CEO will be needed for CCHHS, as well as a permanent CEO.  "There is no process beyond this board for selecting a new CEO," Carvalho said. After a closed session Jay Shannon, current Chief of Clinical Integration, was chosen by the CCHHS board as Interim CEO.

During discussion of a NuCare Service contract for $5,435,854, Carvalho explained that because Oak Forest no longer provides long term care, an RFP was issued and NuCare was selected to provide custodial care for 45-50 patients. The quality of their care is to be monitored by scheduled and unscheduled visits. Lerner cautioned that there should be clear performance criteria, penalties for noncompliance, and good linkage between CCHHS and NuCare staff to coordinate services. Recipients of these services will be patients ineligible for Medicare or Medicaid (primarily undocumented residents); "We don't apologize for that," Carvalho said.

An intergovernmental agreement with the Forest Preserve District will allow for an ADA-compliant, accessible, paved walking trail on the former Oak Forest Hospital property, as well as a facility to explain the history of the property as a former poor farm.

Former CCHHS chair Warren Batts now heads the new CCHHS Foundation. Batts is currently filling board positions and developing strategy for the new Foundation.

Dr. Raju reported:

1. There will be a 90-day extension of CountyCare so patients can receive care during the rollout of ACA; 
2. 72,716 patients were approved for CountyCare as of January 22, a total of 103,000 applications filed (state backlog of nearly 30,000)
3. 80 people are now hired each month, up from 30
4. A contract monitoring team has been added.  A joint planning team of the Illinois Medical District will coordinate the redesign and reconstruction of the Fantus Clinic to become an ambulatory care clinic linked to Stroger Hospital.  Dr Raju recognized Dr. DuMont, who heads palliative care, for her excellence.  Dr. Raju also commended CCHHS board member Carmen Velasquez, retiring as CEO of Alivio Medical Center at the end of January.

Linda Diamond Shapiro, new Chief Strategy Officer, explained her priorities are to find opportunities to improve the system, build leadership, and improve patient experience.  She plans to pull together communications, media, intergovernmental affairs, community relations, policy decision support, and marketing.  Her team will be active in recommending that the County, through CCHHS, hold an HMO license, and by so doing become Provider, Plan, Payer and monitor of Population Health.

Carvalho explained that though there will be new leadership at CCHHS, the plan is in place, and no changes in strategy are anticipated: "The board is committed to the direction we've been on."

Meeting adjourned to closed session at 9:40.    

 Submitted by Linda Christianson

January 15, 2014 Cook County Board Meeting

Dealing with Recycling, Bad Deeds, Criminal Justice and Ethics

This very long Cook County Board meeting was at times difficult to follow, even for some commissioners:  a lot of switching back and forth between committee meetings, the general board meeting, and the consent calendar.  However, several important ordinances/amendments and resolutions were passed, often with lengthy discussion and public testimony.

Recycling:  With a close 8-7 vote in favor, a very long amendment (20 pages) to the Solid Waste ordinance was passed.  This basically describes a new method of inspections by the County of solid waste and recycling facilities (transfer stations).  New fees will be charged to these facilities, reporting requirements are more stringent and frequent, penalties are delineated, and future policies will be formed based on information collected from these facilities.  Objections to this ordinance included the additional fees per ton of waste that would be passed on to the taxpayers/users;  increased record keeping by owners of the facilities;  possible anti-business focus;  and the large number of exemptions in Cook County making this ordinance cover only 1/3 of the county.  Chicago already has a plan in place to cover this and municipal-owned facilities are exempt.  Sponsor Comm. Moore indicated that this ordinance would help encourage recycling and prevent surrounding land from being tainted by waste pollution--particularly in southern Cook County.

Bad Deeds (Unlawful Clouding of Title):  Apparently in Cook County it is easier to steal a house than steal a car--according to Karen Yarborough, Recorder of Deeds.  It appears that for only a small filing fee, a person can change another person's title of land--their home--and then take it over physically by changing locks on the doors and moving in.  Although there is state law prohibiting this,  the County Board passed an additional ordinance that would address this problem by invoking thousands of dollars in fines and hopefully make the enforcement against this quicker and more effective.  (As an aside, homeowners can sign up with the Recorder of Deed's office to get an alert anytime someone changes their land/home title.)

Criminal Justice:  An ordinance amendment and a resolution were both passed with regard to the criminal justice system in Cook County.  The first establishes an Advisory Committee to the Justice Advisory Council Department.  Members of this non-paid committee (the President or designee, 3 members of the CC Board, 1 law enforcement person, 2 social service people), all appointed by the President, would issue a recommendations report at the end of the year regarding violence prevention, intervention and reduction strategies, and programs.  Topics would include gun court, straw purchases of guns, violence with guns.  This was deferred until the next board meeting as some discussions about this committee are still ongoing.
The second is a resolution transferring the court-ordered Prisoner Release Order to the President's Office instead of the Sheriff's Office, where it originated.  This issue has been in the news quite a bit lately, with controversy over who is in charge of releasing more prisoners from the county jail, which tends to get overcrowded.  Objections to this transfer center on whether this process should be under the Judicial branch rather than the President's office.  This still needs to be approved by  a higher authority (State of Ill., U.S.?) before it can be in effect.

Ethics:  Two items that were passed dealt with ethics in Cook County government.  The first is an amendment to the procurement code sponsored by Comm. Suffredin requiring employees to report "skullduggery" in the procurement process to the inspector general.  The second is a resolution sent to the State General Assembly to include Cook County in the state's Ethics Act.  Apparently this was an oversight on the part of the sponsor of the legislation in the General Assembly.

Notes on the processes at the Board meeting:  This observer has attended numerous Cook County Board meetings over the past six years and procedures have markedly improved.  However,  there are still some that make it difficult for the public audience to fully understand what has transpired at the meeting:
1.  The League is pleased that public testimony is now a part of all meetings, but during this meeting's public testimony, many commissioners were engaged in side conversations rather than listening to the speakers.  Although the commissioners themselves may already know the information, this observer found some valuable viewpoints brought up by some outside speakers.
2.  There were  many "last minute" substitute amendments that were not available to the audience--even on-line.  Because the substitution difference was not  explained nor mentioned at the meeting, the public audience did not know what specifics the Board actually passed.
3.  Committee reports which contain resolutions and other important content are sometimes passed as a whole without mentioning the particulars.  At today's meeting, this lead to passage of a Committee Report without it being obvious what was contained in that report.  This is especially difficult for the observer to know when the committee met and passed ordinances, amendments and resolutions just the day before.
This observer hopes some adjustments can be made to help the public better understand and follow the Board Meetings.